妊娠合并乙型肝炎患者血脂及雌激素水平检测的临床意义

Clinical Significance of Detection of Blood Lipids and Estrogen Levels in Patients with Pregnancy Combined with Hepatitis B

目的:探讨妊娠合并乙型肝炎患者血脂及雌激素水平检测的临床意义。方法:选择2014年8月到2017年4月我院收治的妊娠合并乙型肝炎孕妇80例作为观察组,同期选择无乙型肝炎的80例孕妇作为对照组,比较两组的血清HDL-C、TC、TG、LDL-C及雌激素水平,对比两组不同妊娠结局血脂和血清雌激素水平,并以妊娠不良结局作为因变量,以收集的资料、血脂及雌激素水平作为自变量,分析妊娠合并乙型肝炎患者妊娠不良结局的危险因素。结果:与对照组相比,观察组血清LDL-C、TC、TG含量均显著升高,而HDL-C含量明显降低(P<0.05)。观察组与对照组的血清雌激素含量分别为154.20±10.82 pmol/L和88.14±8.98pmol/L,观察组明显高于对照组(P<0.05)。与对照组相比,观察组剖宫产、产后出血、新生儿窒息、胎儿窘迫、妊娠期高血压疾病的发生率均显著增高(P<0.05)。观察组和对照组中妊娠不良结局患者的血清TC、TG和LDL-C含量都明显高于妊娠正常结局患者,而HDL-C含量明显低于妊娠正常结局患者。LDL-C、雌激素、年龄、乙肝发病年限为导致妊娠合并乙型肝炎患者妊娠不良结局的危险因素(P<0.05)。结论:妊娠合并乙型肝炎患者妊娠不良结局的发生率较高,且伴随有血脂异常与雌激素高表达,二者与妊娠合并乙型肝炎的不良预后相关。

Objective： To investigate the clinical significance of detection of blood lipids and estrogen levels in patients with pregnancy combined with hepatitis B. Methods： From August 2014 to April 2017, 80 patients with pregnancy combined with hepatitis in our hospital were selected as the observation group. Meanwhile, 80 pregnant women without hepatitis B were selected as the control group. The clinical data of two groups were investigated and collected. The serum HDL-C, TC, TG, HDL-C and estrogen levels were compared between the two groups. The blood lipids and serum estrogen levels of different pregnancy outcomes in two groups were compared. Logistic multiple regression analysis was performed in the observation group, using adverse pregnancy outcome as the dependent variables and the levels of blood lipids and estrogen as independent variables, to analyze the risk factors of pregnancy adverse outcome in pregnant women with hepatitis B. Results： Compared with control group, the serum levels of LDL-C, TC and TG in the observation group were higher than those in the control group, while the serum level of HDL-C in the observation group was significantly lower than that in the control group （P〈0.05）, and the difference was statistically significant. The levels of serum estrogen in the observation group （154.20± 10.82 pmol/L） was significantly higher than that in the control group （88.14± 8.98 pmol/L, t=8.109, P〈0. 05）. Compared with control group, the occurrence of cesarean section, postpartum hemorrhage, neonatal asphyxia, fetal distress, pregnancy-induced hypertension and so on in the observation group were significantly higher than that in the control group （P〈0.05）. The levels of serum TC, TG and LDL-C in the observation group and the control group were significantly higher than those in the normal outcome group, while the HDL-C content was significantly lower than that in the normal pregnancy group. The LDL-C, estrogen, age, duration of hepatitis B were the risk factors that lead to adverse pregnancy outcome in pregnancy with hepatitis B （P〈0.05）. Conclusion： The incidence of adverse pregnancy outcome in patients with hepatitis B is high, and it is accompanied by dyslipidemia and high-expression of estrogen which can be used as predictors of pregnancy combined with hepatitis B prognosis.